Dear lactnetters,
just something to share... E. is a normal baby born vaginally  at a well reputed hospital. As soon as his mother looks at him,  at birth, she notices two "bumps" on the lower alveolar ridge - moms pick out everything! -  and points that out to the midwife. " What! teeth??, no ma'm, the baby has just been thoroughly checked!" She develops some nipple soreness bilaterally on the next two days, and minor cracks on the third day, when she is discharged home. No mention on the conspicous gum swellings. That night one tooth erupts- mom remembers baby has been very fussy all day long. The second tooth erupts on day five. In the meantime she has been told over the phone by the antenatal class midwife to wear breast shells to promote her cracks' healing. On day seven she goes to her office and "Oh, jee, this baby has got two teeth!" "I have been trying telling this all week long!" mom replies.
The nipple cracks are healing and the brestfeeding is going much better. A couple of days later mom and baby go to the well baby hospital clinic, where a pedodontist is immediately called. She notices that both teeth are very mobile and expresses her concern over the probability that the baby could swallow them  and ,possibly, develop an intestinal obstruction or , worse, inhale them. The pediatrician and pedodontist, while minimizing the procedure, which could be carried out with no need for local anesthesia, seem very anxious to put their hands on the baby, which upsets both dad and mom. Looking for a second opinion, on day 14 they come to my office. The baby has caught up his birth weight and is well. He has got two 3 mm long lower incisors; they are chalky white, sharp and  mobile on the alveoalr ridge. A thin rim of blood -or just erythema?- encircles one of the two, after I gently inspect them. The lower aspect of his tongue is intact. Mom's nipples are intact, slightly "squeezed" on their sides, after the baby's breastfeeding: he, obviously, doesn't open wide his mouth.Mom reports no pain upon latching, as the baby's protruding tongue separates the nipple's skin from his *crouching* teeth. Lovely! Mom and dad had already looked for a second pedodontist's opinion on the same day.
It turns out that he suggested to remove the teeth after a superficial anesthesia, because of their hyper-mobility. He also told them there is no statistics as whether the  safer choice, i.e. removing them or leaving them in place.
Mom will keep me updated on his baby's latch and her nipples' appearance...
ciao from Rome, under  a shy sunny day
M.Ersilia Armeni
pediatrician, neonatologist, IBCLC

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